Melatonin: A 'Magic' Sleeping Pill for Children?

Pediatricians worry as parents increasingly use melatonin to deal with nighttime restlessness

By

Jennifer Breheny Wallace

June 28, 2013 6:23 p.m. ET

My son, who had always been a champion sleeper, was hit with insomnia the fall of his kindergarten year. A new school, a more rigorous academic schedule and the challenge of making new friends kept him up long after I had fallen asleep. He woke up exhausted and arrived home from school sullen and withdrawn. Over the next few months we tried everything to get him to sleep—no TV, warm baths, massage, warm milk.

Our pediatrician finally suggested that I give my son a melatonin supplement to help reset his sleep cycle. Try it for seven days, he said, but it may take longer. That night, with just 1 milligram of melatonin, my son fell asleep within 20 minutes—and woke up the next morning well rested, at last. It worked just as well the second night.

ENLARGE

Chris Silas Neal

At bedtime the third night, he asked, "Mommy, can I have my magic pill to fall asleep?" I began to worry: Was I creating a drug-dependent child? Worse, could this experiment have long-term side effects?

Our bodies naturally produce melatonin, a hormone that is released primarily in darkness and helps to regulate our sleep and wake cycles. Insomniacs and jet-lagged fliers have used synthetic melatonin supplements as a sleep aid for years. Now there is a growing—and, to some doctors, worrisome—trend of using melatonin supplements to help restless children sleep.

Sales of melatonin have risen dramatically over the past five years, according to Nutrition Business Journal. Estimates for 2012 put sales at $260 million; in 2007, the market was just $90 million. Melatonin is available over the counter in the U.S., but in the U.K. and several European countries, the hormone supplement requires a doctor's prescription.

A handful of companies market melatonin directly for children's use, offering flavored, low-dose versions of the supplement. One melatonin manufacturer's website even urges parents to "prepare your child for academic success" by getting him or her to sleep. It cites one study that found "students with C's, D's and F's got about 25 fewer minutes of sleep and went to bed an average of 40 minutes later than A and B students."

Melatonin has been used in pediatrics for over 20 years. An article in the Annals of Neurology in 1991 reported that melatonin successfully corrected the sleep-wake cycle of a blind child with multiple disabilities. Since then, numerous studies, mostly short-term and involving special-needs children, have shown positive results. Doctors say the supplement can be critical in regulating the sleep patterns of children with neurodevelopmental disorders like autism, with few, if any, side effects.

Judith Owens, director of sleep medicine at Children's National Medical Center in Washington, has studied melatonin and children. She said that the supplement appears to have a good safety record, not only with special needs children but with healthy children as well, when used for short periods with a pediatrician's oversight.

Still, some doctors say parents are misusing it. "I've never seen such widespread abuse of any drug or therapy in all my years of practice," said Stuart Ditchek, clinical assistant professor of pediatrics at New York University School of Medicine. One mother told him that "she lines up her six healthy children nightly to give them their melatonin pill." Dr. Ditchek believes the supplement should only be used for the most serious sleep and neurological disorders. The concern, he said, is the lack of long-term clinical studies to see how the hormone supplement interacts with other hormones in the body, potentially affecting fertility or sexual development.

"Parents are using melatonin because they are stressed out," said Michael Breus, a clinical psychologist and board-certified sleep specialist who knows parents that have given melatonin to their children for years at a stretch. "They come home late, eat dinner late, and they think they can just flick an on-off switch for their children to get to sleep."

Some parents have made candid online confessions about why they use the supplement. According to one father's review on Amazon, "OK, yes, as parents my wife and I should do a better job starting the bedtime routine earlier, turning off the TV earlier, limiting sweets, etc., etc. Well, for whatever reason, this is not our strong suit. This 1 mg light dosage of melatonin is very helpful winding our kids down and getting them ready for bed."

As soon as our own son started asking for the "magic" pill, my husband and I stopped giving it to him. Two years later, he still suffers from occasional insomnia. But whenever I get frustrated, I think back to what Dr. Ditchek told me. "For thousands of years our children have been falling asleep without the need for pills," he said. "Giving your healthy child a pill to fall sleep is sending him the wrong message—that he needs a pill to do what should come naturally."

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